Title: HMS Document Number:

Fall Protection Equipment Inspection Checklist CL-GL-HAL-HSE-0604

Approver:
Owner: Rev Date: Rev No: Page:
Director, Global HSE
Global HSE 02.DEC.2016 0 1 of 2
Standards & Performance

Fall Protection Equipment Inspection Checklist

Fall protection equipment shall be visually inspected before each use by the user for damage and wear. Any item
found damaged or defective is to be removed from service, replaced, marked as being unusable and destroyed.

Equipment Inspected by: Inspection Date:

Facility/Worksite: Work/Project:

Inspect Equipment Serviceable If NOT Serviceable Check () all that apply
Check () One
Harnesses/Belts/Lanyards/Ropes
Yes No Cleaned Replaced Removed Destroyed

Wear

Mold/Mildew

Distortion and free from:

Broken Fibers

Pulled Stitches

Discoloration

Cuts

Tears

Scrapes

Damage from:
Fire/Heat

Acid

Or other Corrosives

Hardware Cracks

Sharp Edges

Burrs

Additional manufacturer
recommended inspection points

Snap hooks close properly and lock

tightly

Buckles work properly

Lifeline anchors and mountings are

not loose or damaged

Comments:____________________________________________________________________________________

Printed versions of this document are considered UNCONTROLLED.

This is the minimum Halliburton Company Standard. If local, country, or contractual requirements exceed this standard then those requirements
must be followed.
 Title: HMS Document Number:
Fall Protection Equipment Inspection Checklist CL-GL-HAL-HSE-0604
Approver:
Owner: Rev Date: Rev No: Page:
Director, Global HSE
Global HSE 02.DEC.2016 0 2 of 2
Standards & Performance

Revision Date Rev. No Revised By Summary of Key Changes

02.DEC.2016 0 Ed Devol New Document
For questions, comments or previous versions of this document please send using the Global HSE Support Request Form.

Printed versions of this document are considered UNCONTROLLED.

This is the minimum Halliburton Company Standard. If local, country, or contractual requirements exceed this standard then those requirements
must be followed.